Age-In-Place® (AIP) Volunteer Application
We're so glad you're interested in volunteering! Age-­In-­Place® firmly believes older adults can age successfully in their own homes and neighborhoods with community support. Our program is a vital part of that support system; empowering seniors in DC to age independently and with dignity.

After filling out the AIP Volunteer Application, you will be required to attend a Volunteer Orientation prior to volunteering. Here is the Eventbrite link to the Orientation: Please feel free to email the Age-In-Place Staff at or call our offices at 202-635-9384 ext 102 if you have any questions.

Email address *
Contact Information
Name *
Phone Number *
Email Address *
Mailing Address *
Date of Birth (You must be at least 12 years old) *
Place of Employment and/or School Attending
Do you have allergies or physical conditions to consider when volunteering? *
Emergency Contact (Name & phone number) *
Volunteer Details
How do you want to volunteer? (check all that apply) *
Do you have any skills you can and want to donate? (ex: photography, IT, lawn mower repair, etc) *
How many hours per month will you commit?
Anything else we should know? (ex. You want to set up a group volunteer day for friends or coworkers, etc)
Volunteer Commitment
In consideration of participating as a Seabury Resources for Aging volunteer, I hereby release Seabury Resources for Aging and its employees from all liabilities and claims arising from or in connection with my volunteer work for Seabury Resources for Aging, including any liabilities or claims arising from or in connection with Seabury Resources for Aging's negligence or fault.
If, for example, I injure myself, am injured by others, become ill, or sustain damage to or theft of my personal property while volunteering for Seabury Resources for Aging, I agree not to initiate any claim against Seabury Resources for Aging resulting from such circumstances. I will notify the volunteer coordinator or another Seabury Resources for Aging staff member immediately if I am involved in any injury, illness, damage, theft or other incident during the course of my volunteer work.

I agree to adhere to the Seabury Resources for Aging's guidelines for volunteers and all other policies and procedures of Seabury Resources for Aging, in each case as revised from time to time, and to treat with respect all clients who receive the services of Seabury Resources for Aging. I understand that I may have access to names and personal information about current clients, staff members, or other volunteers. I agree that I will keep that information private, not use it for the purpose of solicitation, and not disclose that information to any person who is not affiliated with Seabury Resources for Aging.
I understand that placements are not permanent. As a volunteer I may decide to stop volunteering at any time. Volunteers are asked to inform their volunteer coordinator and to give as much notice as possible. I understand that I am ineligible to volunteer if I have a conflict of interest with the organization, whether personal, philosophical, or financial.

I will follow the volunteer coordinator’s instructions and understand as a volunteer that I am responsible for following safe work practices. I understand that I will conduct myself with an acceptable level of behavior which includes abstaining from horseplay, practical jokes, threats, violence, or intimidation while volunteering.

I understand that Seabury Resources for Aging does not discriminate on the basis of race, creed, color, religion, national origin, citizenship status, sex, age, disability, marital status, sexual orientation, disability, or political affiliation. Volunteers are expected to act in accordance with this policy. I understand that as a volunteer I am authorized to represent the organization only as specifically indicated by my volunteer description or by the volunteer coordinator.

I am aware this agreement contains a limitation of Seabury Resources for Aging's liability and a release of claims. I have read and understand the content of this agreement and sign the Volunteer Application and Waiver as well as the Volunteer Policies and Procedures knowingly and voluntarily.

By signing my name below, I have agreed with the statements above. *
Never submit passwords through Google Forms.
This form was created inside of Seabury Resources for Aging. - Terms of Service - Additional Terms